Top Line: Patients with higher BMI generally fare better with head and neck radiatiotherapy.
The Study: But it has to do with more than extra reserve for anticipated weight loss. We’re talking about conservation of muscle, of course. A retrospective cohort of 1,187 patients receiving definitive head and neck radiotherapy at UCLA between 2014–2024 included 659 with pretreatment CT simulation scans suitable for automated volumetric body composition analysis. After multivariable adjustment, overweight (HR 0.70) and obese (HR 0.67) patients had lower mortality than patients with healthy BMI. Among patients with imaging data (n=659), each standard deviation increase in skeletal muscle index was associated with improved overall survival (HR 0.67), whereas each standard deviation increase in intermuscular adiposity index was associated with worse survival (HR 1.28).
TBL: The BMI survival paradox may obscure meaningful differences in muscle reserve and adipose infiltration. | Jank, JAMA Otolaryngol Head Neck Surg
The Study: But it has to do with more than extra reserve for anticipated weight loss. We’re talking about conservation of muscle, of course. A retrospective cohort of 1,187 patients receiving definitive head and neck radiotherapy at UCLA between 2014–2024 included 659 with pretreatment CT simulation scans suitable for automated volumetric body composition analysis. After multivariable adjustment, overweight (HR 0.70) and obese (HR 0.67) patients had lower mortality than patients with healthy BMI. Among patients with imaging data (n=659), each standard deviation increase in skeletal muscle index was associated with improved overall survival (HR 0.67), whereas each standard deviation increase in intermuscular adiposity index was associated with worse survival (HR 1.28).
TBL: The BMI survival paradox may obscure meaningful differences in muscle reserve and adipose infiltration. | Jank, JAMA Otolaryngol Head Neck Surg